The big question on seniors’ minds is will Medicare pay for my service. Most important thing to note about Medicare is it is basic coverage, it is not intended to cover all services.
What Does Medicare Cover?
Original Medicare is broken down into two parts: Part A, hospitalization coverage, and Part B, medical coverage. Part A covers things like hospital stays, skilled nursing, hospice, and home health services. Part B covers getting a second opinion before surgery, clinical research, mental health, and durable medical equipment. (Source)
How Much Does Medicare Cover?
The following is how Original Medicare’s coverage works:
Part A Costs
- Monthly premium for most people: $0
- Deductible per benefit period: $1,676
- If hospital stay is less than 60 days only pay deduct
- Hospital stay days 61-90: $419 per day
- Lifetime hospital reserve days (60 days): $838 per day
- After lifetime reserved days: 100% of hospital costs
- Skilled Nursing Facility days 1-20: $0
- Skilled Nursing Facility days 21-100: $209.50 per day
- Hospice care: $0*
*Hospice care is usually covered at 100%, but it may have some excess charges that aren’t covered and generally require a 5% payment.
It is important to note that an average 3 day hospital stay costs $30,000, and if you go past your lifetime reserve days you could be paying a significant amount of money.
Part B Costs
- Monthly premium: $185
- Deductible: $257
- Coinsurance/Copays: 20-40%
- Excess Charges: Vary
Ways to Be Financially Covered With Medicare
There are a few ways to limit your Medicare financial responsibility. You may want to consider a prescription drug health plan to further limit your out of. You may also choose to enroll in a Medicare Advantage plan that creates a small network of doctors and hospitals but with an out of pocket maximum of as high as $9,350 OR a Medigap plan that covers the gaps of Original Medicare. With a Medigap Plan F you won’t pay anything out of pocket after your premium, as long as Medicare covers its.
We know how tough it can be to pick the “perfect” Medigap plan—especially when you’re new to Medicare. But here’s the thing: even if you later realize the plan you picked isn’t right for you, you might have options to make a switch. During your first six months of Part B, you have guaranteed approval. After that, certain state rules like the Birthday Rule may help. And if you need to go through underwriting, our Instant Medigap Underwriting Checker tool can help you see your chances ahead of time. Questions? Call us—we’re happy to help, for free.
For further questions about what Medicare covers or click here if you want a Medicare Insurance quote.